Where does one start analysing the recent claim by the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, that Nigeria is becoming a hub for quality health care and a destination choice for patients from the West African subregion and other parts of the world? Is it from the fact that as at the time he was making the statement on Tuesday, the number one citizen of the country, President Bola Tinubu was almost ready for a private visit, (believed by many to be health check related) to Paris, France the following day? Or, that the minister did not explain what he meant by “quality healthcare” nor did he tell the State House correspondents the number of patients that come to Nigeria from the USA and the UK for treatment and why.
Are they Nigerians in the diaspora visiting Nigeria and receiving treatment? Do the so-called people from all over the world come to Nigeria for medical treatment because Nigeria offers the best medical care better than anywhere in the world? No doubt, there may be some people who visit hospitals in Nigeria, maybe for fertility treatment due to certain restrictions in the countries they reside, who come to consult some particular health experts or those that find the treatment of certain ailments cheaper in Nigeria. There also exist some specialised hospitals in the country, particularly in Lagos and Abuja, who do attract patients from neighbouring West African countries for treatments in such areas as organ transplants, cardiology, fertility treatments, and advanced surgeries. But on a global scale, can Nigeria be regarded as a top destination for medical tourism? How did the minister arrive at that
And talking of quality healthcare, as earlier stated, it would have been nice if the Minister had given us the indices he used to arrive at his assertion and his own meaning of quality healthcare. Experts have defined quality healthcare as medical services that are effective, safe, timely, patient-centred, equitable, and efficient. It ensures that patients receive the right care at the right time, leading to better health outcomes. This means that, for healthcare to be considered quality, the treatments and interventions should be based on scientific evidence and best practices to improve patient health; it should minimise risks, errors, and harm to patients; patients should receive care without unnecessary delays; it should respect and respond to individual patient needs, values, and preferences; it should be accessible to all, regardless of socio-economic status, race, gender, or geographic location.
Above all, it should be efficient – resources should be used wisely to avoid waste and keep healthcare costs manageable. Are these the case in Nigeria? It is no hidden fact that many hospitals and clinics in the country, especially the public hospitals lack basic amenities like clean water, stable electricity, and modern medical equipment.  Rural areas suffer from a lack of healthcare facilities, forcing patients to travel long distances for medical attention. Many doctors, nurses, and other medical workers migrate abroad (japa syndrome) due to low wages and poor working conditions. The doctor-to-patient ratio is far below the WHO recommendation. Not once have we seen a doctor dozing off while consulting patients due to fatigue and heavy workload. All the doctors’ strike actions for these reasons have not brought about a significant change.
How easily do patients receive medical attention in our hospitals and clinics? In most government hospitals, patients spend almost a full day or more to see a doctor. When the doctor is a consultant, the waiting period will definitely be longer.  And how affordable are the treatments and the drugs? The National Health Insurance Scheme (NHIS) was established in 1999 in response to increased out-of-pocket payments and the call for a movement towards Universal Health Coverage (UHC). Since the scheme started its operations in 2005, how many people have enrolled in the programme? The current Minister for Education, Dr. Tunji Alausa, while serving as the Minister of State for Health in May 2024 said that the government had allocated dedicated funds and initiated collaborations to enhance primary healthcare services and expand health insurance coverage and that the president had mandated them to increase coverage from about seven million then to about 50 million people.
Today, records show that only a small percentage of the citizens are still covered by the scheme. According to a report by the Journal of Global Health Economic and Policy, less than 5 percent of Nigerians are enrolled in NHIS, while 70 percent still rely on out-of-pocket payments, making healthcare unaffordable for the poor The challenge of poor drug regulation, counterfeit medicine, inadequate funding, poor emergency response, inconsistent government policies and corruption, poor sanitation and hygiene are yet to be dealt with. How then do we have quality healthcare in Nigeria? What about the careless and nasty attitude of healthcare providers towards the patients. Many Nigerians are left with permanent scars and disabilities due to the negligence of so-called healthcare experts who treated them.
Sure, medical negligence is not peculiar to Nigeria but it has become a constant occurrence in our health facilities and must be looked into by the Medical and Dental  Council of Nigeria, the Nigeria Medical Association and other relevant authorities. To take the nation’s healthcare system to the desired eldorado, a combination of policy reforms, increased funding, infrastructure development, workforce enhancement, attitudinal change among the healthcare providers and reduction of corruption in the health sector is necessary. Pate on Tuesday revealed that federal government has approved the sum of N12 billion for Magnetic Resonance Imaging, an advanced diagnostic equipment, across six tertiary health institutions in addition to Nigeria’s ratification of the African Medicines Agency (AMA) Treaty, which aims to harmonise medical regulatory standards across the continent.
That is a commendable step by the government if only the government will ensure that the money when released will be used for the stated aim and the right equipment purchased and regularly maintained. It is also important that the government allocates at least 15 percent of the national budget to health, as recommended by the Abuja Declaration. They should explore public-private partnerships (PPPs) to attract investments in healthcare infrastructure. There is also the need to upgrade and equip existing hospitals with modern medical technology, establish more primary healthcare centers (PHCs), especially in rural areas and invest in digital health solutions such as telemedicine to improve access. The issue of shortage of healthcare workers must be addressed through improved salaries, benefits, and working conditions.
Incentives (such as scholarships, housing, and career growth opportunities) should be regularly offered to retain healthcare professionals. Other important measures to be taken include expansion of the NHIS to cover more citizens, including the informal sector; introduce community-based health insurance programmes to increase access to affordable healthcare; the government, both federal and states, should subsidise low-income families to reduce out-of-pocket expenses.The authorities should strengthen immunisation programmes to prevent disease outbreaks and promote health education campaigns on sanitation, hygiene and healthy lifestyles. The National Agency for Food and Drug Administration and Control (NAFDAC) should be empowered to monitor and regulate pharmaceutical products more effectively, while the law enforcement agencies should do more in the area of enforcing stricter penalties for drug counterfeiters.
Implement technology-driven tracking systems to detect and remove fake drugs from circulation.The government should also increase funding for medical research and encourage local drug production. Partnership with universities and research institutions to develop innovative health solutions will certainly be productive. Government should also consider supporting the development of traditional medicine through scientific validation. As Africans, many Nigerians in the diaspora believe in the potency of herbs. A story was recently told of how some Nigerians make money by sending herbal medicine to Nigerians abroad. So, developing and properly regulating this sector might be the major attracter of patients. To have people come from all over the world to Nigeria, with the assurance that they will get the best of medical care here is the wish of many Nigerians.
Maybe that will reduce the president’s trip to France and save the nation some money. But achieving that goes beyond rhetorics or making political statements. Let there be more actions than words

Calista Ezeaku

The Economic Community of West African States (ECOWAS) announced recently that the three-member nations where coup plotters overthrew elected governments had finally. The three exiting West African countries of Mali, Burkina Faso and Niger Republic. I have nothing but condemnation for unelected soldiers overthrowing elected representatives. Interstingly, ECOWAS leaders had a summit, where they said the organisation should be less about the regional leaders and more about the people. They emphasised “ECOWAS of people”.
The leaders wanted people to be more interconnected, not just the leaders who routinely held summits. So, they introduced measures to ensure that people had this sense of community with people across member nations. How the latest decisions taken by ECOWAS leaders regarding the three exiting nations contribute to this is my focus here. In the statement the leaders put out, I noticed they chose to leave the coup plotters to do their thing while ensuring that channels were left open for contact between their citizens and the rest of the people in the region.
I believe the thinking of the ECOWAS leaders aligns with the views I have been expressing online in the past few months regarding this matter. They are as follows: Earlier on when Mali, Burkina Faso, and Niger Republic announced that they formed an alliance, I stated that they could have their alliance and still be in ECOWAS. Actually, ECOWAS, like other international bodies, is an amalgamation of nations involved in different alliances. The European Union and African Union were formed by nations that had diverse alliances among themselves. In West Africa, there were the French-speaking and English-speaking nations in alliances with France and Britain at the time ECOWAS was formed. There are other alliances based on the currency that French-speaking ECOWAS members use i.e. the CFA. Some economic and military sub-alliances remain ECOWAS functions. Even currently some West African nations jointly combat insurgency and other challenges. ECOWAS recognises them and encourages their initiatives as such help promote ECOWAS’ regional integration objective.
Furthermore, ECOWAS should take its time regarding the three exiting nations since we know that one administration goes and another comes, but a nation and its people remain. Policies in nations can change over time depending on who is in power. Therefore, ECOWAS leaders should take a long-term view of relations with the exiting nations, noting that international relations are not conducted just for the short- and medium-term, but mostly the long term. There is a long-term for the three nations in question. Whoever thinks they can rule forever with the gun, having the illusion that they are the only messiah their people have, will ultimately face reality.
In addition, ECOWAS leaders should undertake measures which ensure that democratic forces in the three nations are assisted and strengthened to demand a return to civil rule. This to me is the viable route to follow for now. Nonetheless, my expressed views did not gloss over the grudges civilians in the three nations might have against their elected leaders. Arguments about discontent among citizens are ones that some use to justify soldiers in politics. To me it is unacceptable. I stated after the latest coup in the Niger Republic that if people did not like the manner an elected leader frolicked with foreign nations perceived to be fleecing them, the better solution was to mobilise and elect leaders who represented their view on such matters.
To me, soldiers in politics are never the solution to a country’s problems. Soldiers would regiment abracadabra, introducing populist policies that are not assimilated by citizens, and when they go the same citizens return to power. We have seen this across the continent, and I am surprised some still praise soldiers in politics for any reason whatsoever. The reality is that after the initial welcome party, citizens who are muzzled by draconian laws that soldiers make would begin to gather around a cause to return to civilian rule. If this is resisted, the confusion that follows creates conditions for whatever dictators are built to be destroyed. It happened in Libya and other African nations. In Guinea, another West African nation where coup plotters are in power, civilians have begun to stage protests over the agreed transition programme that coup plotters repeatedly ignore.
Back to the thinking of ECOWAS leaders when they announced the final withdrawal of the three nations. They say ECOWAS member nations would continue to recognise all passports and identity cards bearing the ECOWAS logo held by citizens of Mali, Burkina Faso, and Niger Republic. The countries would also remain in the bloc’s free-trade scheme. Interestingly, the chairman of the alliance formed by the coup plotters and Mali’s dictator said months ago that the right of ECOWAS citizens to enter, circulate, reside, establish and leave the territories of their new alliance would be maintained. So, coup plotters too want to maintain relationships with people from ECOWAS member nations. Lately, the dictator in Burkina Faso attended the swearing-in ceremony of Ghana’s new president. The three landlocked nations know they cannot close their borders; if they do they will suffer the consequences more. And who casually crosses borders for all manner of reasons? People. The three heads of coup plotters can shut themselves up in their respective nations’ capitals, but their peoples continue to meet others as one community as ECOWAS leadership envisions it.
I think the people-to-people aspect in regional relations has informed most measures adopted by ECOWAS leadership regarding the exiting nations. They should continue on this path. They isolate the coup plotters that way. Coup plotters can gather under their alliance, but a sense of community shared by their people with other people in the region will outlive their different administrations. This consciousness of one community actually informed how ECOWAS leaders did not invade the Niger Republic to restore the ousted elected leader as initially planned. For instance, it took the intervention of the traditional and religious institutions in northern Nigeria, who spoke persuasively about their bonds with peoples across the Nigerian-Nigerien borders for President Bola Tinubu to suspend the plan.
The same sense of a shared community made state governors, traditional leaders, and policymakers from Nigeria, Niger Republic, Chad and Cameroon gather lately for the Lake Chad Basin Governors’ Forum.
Ajibade wrote in from Lagos.

There they discussed mutual challenges in their localities and how to alleviate them. Meanwhile, worries expressed by some about the withdrawal of the three nations are legitimate. However, I have been stating that those who withdraw have more to lose than ECOWAS members. If security worsens across West Africa, ECOWAS member nations have better support systems. Mali, Burkina Faso, and Niger Republic now depend on Russia for support. That is a nation that, though it can help create a nuisance situation, is itself having internal and external challenges.
As things stand, the three exiting nations and their Russian allies suffer heavy losses at the hands of insurgents. Niger Republic’s plan to export crude oil has met with setbacks in Benin Republic. Ultimately, we should not forget that certain human experiences made Libyans under Ghaddafi, for instance, become disenchanted. It made them desire to connect better with the rest of the world and be led by elected representatives. Peoples of the three nations exiting ECOWAS cannot be different if political history is anything to go by.

Tunji Ajibade

In a calculated attempt to tarnish the reputation of Governor Siminalayi Fubara, Lere Olayinka, the self-styled Senior Special Assistant on Public Communication and Social Media to FCT Minister, Nyesom Wike, stormed News Central TV with a cocktail of lies, half-truths and unfortunate distortions. This desperate smear campaign demands a bold response to expose the true mastermind behind the political turbulence rocking Rivers State. Olayinka harped on the current situation of the Rivers State House of Assembly, highlighting the presence of only three (3) active members. Yet, he conveniently glossed over the real story of Martin Amaewhule and his co-defectors who cowardly abandoned their constituencies and their mandates by defecting to the APC without due consultation. These former legislators, by law, automatically vacated their seats, but Olayinka lacks the courage to admit this truth.
When asked about Wike’s involvement in Rivers State’s political turmoil, Olayinka could not deny the undeniable. Wike is not only a major player in this crisis but also its architect. His meddlesome tendencies and attempts to control the state from Abuja have been met with stiff resistance from Rivers people who are fed-up with his overreach. Olayinka’s claim that Wike elevated Governor Fubara from “a mere cashier” to governor reeks of pettiness. It is an insult to Fubara’s track record of service and to the Rivers people who overwhelmingly voted for him. The truth is, Governor Fubara was instrumental to any success Wike claims during his time as governor, especially in financial prudence and project execution, Olayinka can challenge me to a debate if in doubt. Mr. Olayinka falsely accused Governor Fubara of disobeying President Bola Ahmed Tinubu.
The irony, however, is glaring. The real defiance came from those who President Tinubu called his “newborn babies,” only to disown him days later. Aside the impeachment attempt, Wike’s ill-advised push for these individuals to defect to the APC is at the root of the political mess they currently face. Olayinka’s admission that Fubara is the governor and wields the “red biro” underscores one truth: Governor Siminalayi Fubara is in Charge. While his employer may attempt to pull the strings of discord, Rivers people have declared unequivocally that the era of external interference is over. Sir Fubara is taking bold steps to restore dignity and prioritise the state’s interests. Also, Olayinka’s attempt to draw parallels between Rivers State and Kogi State only highlights his lack of understanding of Rivers politics. Rivers people are not Kogi people.
They will not accept a situation where commissioners or key appointments are dictated from only one man, as Wike attempted to do. Rivers people have spoken, and their stance is non-negotiable. Olayinka’s laughable claim that Governor Fubara is dining with those who opposed his emergence shows a lack of political depth. Almost everyone standing with Wike today—including Magnus Abe and Chidi Lloyd—at one time opposed his own governorship bid. Politics evolves and alliances shift. Governor Fubara is focused on governance, not on petty vendettas. Assuming, without conceding, that Governor Fubara did not address Rivers people during the campaign, the blame lies squarely on Wike, who perhaps never allowed him to speak. He almost succeeded in extending this overbearing tendencies into the governance of the state, but Rivers people are saying “No” to this meddlesome interference.
The glaring contradictions in Olayinka’s rhetoric can tell you why Fayose failed woefully in Ekiti State despite all his noise. Just like his principal, Olayinka has mastered the art of bluster without substance. When pressed on what Wike wants from Governor Fubara that he is not getting, Olayinka could not provide an answer. The truth is simple: Wike desires absolute control, but Governor Fubara and Rivers people have drawn the line. Olayinka’s interview on News Central TV was nothing but a desperate attempt to deflect attention from Wike’s political blunders and meddlesome tendencies. The records are clear: Governor Fubara is focused on the interests of Rivers people, while Wike and his cronies remain trapped in a web of personal ambition. The good news is that Rivers people know the truth. Governor Fubara is acting decisively and Rivers State is moving forward under his leadership. No amount of propaganda or falsehoods can change this fact.

John Martins
Martins wrote in from Port Harcourt.